Receipt-form.



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998,769, Patented May 30,1911.

E, LEE/Z HE NHHIS l'zrlll ca.. WASHINGTON. u. c.

UNITED STATES PATENT OFFICE.

EUGENE I-I. FELL, OF ATLANTA, GEORGIA.

RECEIPT-FORM.

To all 'whom it may concern:

Be it known that I, EUGENE H. FELL, a citizen of the United States, residing at Atlanta, in the county of Fulton, State of Georgia, have invented certain new and useful Improvements in Receipt-Forms; and I do hereby declare the following to be a full, clear, and exact description of the invention, such as will enable others skilled in the art to which it appertains to make and use the same.

The invention relates to a receipt. and more particularly to the class of receipts for use on passenger trains, street cars, omnibuses or the like.

The primary object of the invention is the provision of a receipt in which the amount of cash fare paid by a passenger will be recorded so that the passenger can be supplied with a stub evidencing the cash fare paid and likewise duplicating such evidence by stubs to the general passenger agent or conductor and an auditor, thus making it impossible for the holders of the stubs to change or alter the same to the advantage of either the party paying the amount or the party to which the same has been paid.

Another object of the invention is the provision of a receipt form of the character described in'which triplicate sections may be distributed to the payer of cash, the payee and to a third party, thus obviating the possibility of fraud and at the same time removing temptation to the party collecting the payment of cash for the reason that such person will be aware that evidence of such payment of money is possessed by the payer and a third party.

A further object of the invention is the provision of a receipt form which is simple in construction and one that will enable triplicate receipts to be issued in a ready and convenient manner and also one that is inexpensive in the cost of production.

In the drawings accompanying and forming part of this specification is illustrated the preferred form of embodiment of the invention, which, to enable those skilled in the art to carry the invention into practice, will be set forth at length in the following description while the novelty of the invention will be pointed out in the claims succeeding the description.

In the drawings :--Figure 1 is a plan view of a receipt form constructed in accordance with the invention. Fig. 2 is a similar view Speccaton of Letters Patent.

Application led April 5, 1910.

Patented May 30, 1911. Serial No. 553,595.

showing the receipt form separated into triplicate stubs.

Similar characters of reference indicate corresponding parts throughout the drawings.

Referring to the drawings by numerals, 5 designates generally a receipt form or blank comprising a strip of sheet material 6 preferably of paper although it may be formed from any other suitable material, and this sheet is provided near opposite ends with spaced parallel slits 7, the saine being disposed longitudinally of the sheet and each terminating at one end spaced from the medial portion of the sheet and at its end spaced from the extremity of the sheet, the slits being co-extensive and of corresponding length to each other to form column spaces therebetween.

In the medial space portion of the sheet on one face thereof is provided printed matter or indicia indicating by whom the receipt form has been issued, the number of the receipt or either the number of the vehicle on which the receipt has been issued and the conductor or party distributing such receipt.

Between the slits 7 is provided printed matter or indicia designating duplicate columns of money values ranging consecutively from naught to nine, the columns of money values being designated by characters representing sums of money, for instance the columns ranging in divisions of dollars, dimes and cents, the money values in one column between each slit being expressed in digits while the remaining column is eX- pressed in number names or words.

In the digit columns between the slits near lthe upper end of the sheet 6 their upper terminal digits are arranged directly opposite the division money valuations thus bringing their opposite terminal digits directly opposite the number name Eight in the number name columns, while the digits between the slits near the lower end of the sheet are arranged so that the lower terminal digits are disposed opposite the sum valuations whereby their opposite terminal digits will be disposed opposite the number words or names One in the number name columns.

The space beyond the slits 7 atthe lower end of the sheet 6 is provided with printed matter designating the number of the receipt issued or the train number upon which the receipt has been issued, the day and year of issuance of the receipt and the title Auditofs stub while the space beyond the slits 7 at the upper end of the sheet is provided with printed matter giving forth the number of the receipt or the train number upon which the receipt has been issued and the title General passenger' agents stub. rlhe medial space between the slits 7 is also provided with printed matter designating the day and year of issuance of the receipt.

rlhe receipt form is adapted to be separated into triplicate portions by tearing the sheet crosswise so to intersect the slits 7 whereby each segregated portion of the form will indicate the exact amount of cash paid by the payer to the payee, for instance as illustrated in Fig. 2 presuming that a person has paid the sum of $3.45, the receipt form is severed into triplicate receipt portions showing in general passenger agents stub, auditors stub and passengers stub the said sum of cash paid by the passenger.

lt is, ot' course, to be understood that the sum denominations or money value designations in the columns between the slits as printed thereon by the showing in the drawings may be varied as the occasion may require.

lVhat is claimed, is :i

l. A receipt oit the class described, comprising a sheet having above and below its center a plurality of columns of money value designations in words and numbers, and a slot therein between said columns, said numbers in the columns above the center of the sheet being disposed opposite the words of a respective column and having a value of one greater than the word designations opposite thereto in said column, and the numbers in the columns below the center of the sheet being also disposed opposite the words in a respective column and having a value of one less than the word designation in said column, whereby when the sheet is severed into triplicate portions the intermediate portion will indicate at each end in words a money value identical with that indicated in numbers by each terminal portion.

2. A receipt of the class described, comprising a sheet having above and below its center a plurality of columns oit money willie designations in words and in numbers, said numbers in the column above the center of the sheet being disposed opposite the words of a respective column and having a value or' one greater than the word designation opposite thereto in said column, and thc numbers in the columns below thc center oli' the sheet being also disposed opposite the words of a respective column and having a value ot' one less than the word designation in said column, whereby when the sheet is severed into triplicate portions the intermediate portion will indicate at each end in words a money value identical with that indicated in numbers by each terminal. portion.

ln testimony whereof, l al'lix my signature, in presence of two witnesses.

EUGENE H. FELL. lVitnesses:

lV. H. Simili', E. L. REED.

Copies of this patent may be obtained for ve cents each,

by addressing the Commissioner of Patents.

Washington, D. C. 

